Supreme Court Tests Texas' New Restrictions On Abortion

The examining rooms in the Fort Worth clinic do not meet the emergency-room-like standards of the Texas abortion law known as HB 2. It would cost more than a million dollars to upgrade this facility, and the clinic's operators say it would be forced to close.

The examining rooms in the Fort Worth clinic do not meet the emergency-room-like standards of the Texas abortion law known as HB 2. It would cost more than a million dollars to upgrade this facility, and the clinic’s operators say it would be forced to close. Barry Gordemer/NPR hide caption

toggle caption Barry Gordemer/NPR

Even with the death of Justice Antonin Scalia, Wednesday could mark a potential turning point for the Supreme Court on the subject of abortion. At issue is whether a new Texas law imposes restrictions that unconstitutionally limit a woman’s right to terminate a pregnancy.

Last June a federal appeals court upheld the law. If the Supreme Court agrees, it would mean a dramatic cutback on abortion rights across the country, and potentially a stepping stone toward the reversal of Roe v. Wade.

The Texas Omnibus Abortion Bill, known as HB 2, requires all abortions — either surgical, or medical, meaning with pills — to be done in ambulatory surgical centers. Such facilities are mini-hospitals, with wide corridors, large operating rooms, and advanced HVAC systems, among other requirements. A second provision requires doctors performing either surgical or medical abortions to have admitting privileges at a hospital within 30 miles of the clinic.

The state says it enacted these provisions to protect the health and safety of women. Virtually the entire established medical profession, both in Texas and nationally, disagrees.

The American Medical Association and the American Academy of Family Physicians, among others, have joined the American College of Obstetricians and Gynecologists in telling the justices that these provisions are “unnecessary” and “harmful” to women’s health and safety. The major medical groups contend that the law erects gratuitous barriers to abortion, adds needless expense, and — by causing the closure of so many clinics — creates significant delays that sometimes push abortions into the second trimester.

At the Fort Worth, Texas, abortion clinic we visited, the protesters were out early in the morning — and so were the patients, some of whom had traveled long distances by car and bus to get here.

“I figured there’d be another clinic in my city, and come to find out there wasn’t,” said one woman, who like all the women we spoke to declined to give her name for fear of harassment.

She had taken the day off, arranged for child care and driven nearly 150 miles from home to get an abortion.

Prior to HB 2, there was in fact a clinic in her home city, but it closed on the day the new Texas law went into effect in 2014. Indeed, before the law was enacted, there were 41 abortion clinics in the state. Today there are 19, and if both of the provisions at issue in Wednesday’s case are upheld, at least ten of those 19 would close, including this one in Fort Worth.

For one of the bill’s co-authors, the issue is a personal one: State Rep. Jason Isaac says his mother was born as the result of a rape.

“I don’t believe that I would be here today conducting this interview if Roe v. Wade were in effect in 1944,” Isaac told NPR. “We can’t end abortion in Texas, but we can make it as safe as humanly possible.”

Texas Solicitor General Scott Keller will tell the justices that ten women per week visit emergency rooms for complications from abortions, and that the ambulatory surgical center standards are necessary for dealing with more acute emergencies, “ensuring that EMTs can have access to the facilities” and that “there’s not a maze of hallways.”

Doctor Bhavik Kumar has been performing abortions at the Fort Worth, Texas clinic for about a year. He calls abortion a simple procedure and he's had no complications that required a woman to be hospitalized since he's been there.

Doctor Bhavik Kumar has been performing abortions at the Fort Worth, Texas clinic for about a year. He calls abortion a simple procedure and he’s had no complications that required a woman to be hospitalized since he’s been there. Barry Gordemer/NPR hide caption

toggle caption Barry Gordemer/NPR

At the Fort Worth clinic, hallways are only a little more than half the 8-foot width of the state law requirements — but, as Dr. Bhavik Kumar points out, wide enough for a stretcher. In case of an acute emergency, he says, a clinic staffer would wait outside to direct EMTs to the appropriate back door so that they would have quick and easy access to the hallway and procedure rooms.

The doctor says that in his year at the clinic he’s had no emergencies requiring outside medical help.

“It’s a simple procedure — about five to eight minutes, depending on how far along they are,” Kumar says.

Kumar notes that there is no general anesthesia, as is necessary for colonoscopies, liposuction and other procedures that aren’t as strictly regulated in Texas.

“Actually, it’s much safer than colonoscopy,” says Dr. Hal Lawrence, executive vice president and CEO of the American College of Obstetricians and Gynecologists. “As time has moved forward, we have seen how safe abortion is.”

Indeed, one study published in the American Journal of Public Health found that major complications for first trimester surgical abortions occur in one in 2,000 of all such procedures.

Texas Solicitor General Scott Keller will argue the state's case before the U.S. Supreme Court. He says the Texas abortion law, known as HB 2, is designed to protect women's health.

Texas Solicitor General Scott Keller will argue the state’s case before the U.S. Supreme Court. He says the Texas abortion law, known as HB 2, is designed to protect women’s health. Barry Gordemer/NPR hide caption

toggle caption Barry Gordemer/NPR

Texas’s Keller maintains that in fact there have been more complications from medical abortions than surgical abortions. That, he says, is among the reasons the state law requires all abortion doctors to have privileges in a nearby hospital.

“It’s not as if abortion is completely safe, without any complications,” Keller says. “Everyone admits that there can be significant health consequences from these complications.”

But the brief filed by major medical associations counters that, in modern medicine, doctors increasingly are giving up hospital privileges to in-hospital doctors. And, says Lawrence, if an an abortion patient does go to the hospital with some sort of complication, “there are obviously emergency room physicians there, and OBGYNs at those hospitals, that can help.”

Most such complications, he adds, involve bleeding not significant enough to require hospitalization.

Lawyer Stephanie Toti, representing the clinics, will tell the Supreme Court on Wednesday that if the admitting privileges and ambulatory surgical center requirements truly offered a health benefit, they would apply across-the-board to other similar — and, indeed, more dangerous — outpatient procedures.

“The fact that Texas has singled out abortion by itself for the imposition of these requirements, shows that their true purpose isn’t to improve patient health and safety; it’s just to burden abortion,” she says.

The Supreme Court has allowed states to regulate abortion differently from other procedures, but the court ruled in 1992 that states may not impose an “undue burden” on a woman’s constitutional right to terminate a pregnancy.

Texas argues that there is no undue burden here. Keller observes that even if many more clinics are forced to close, “every metropolitan area in Texas that has a clinic today will still have one.”

The clinics counter that so many clinics have had to close under the law that vast expanses of Texas, the second-largest state in the country, already are uncovered — and that the remaining clinics have long wait times.

That was borne out by the women we met at the Fort Worth clinic. One woman in her twenties raced to the clinic when there was an unexpected cancellation, allowing her to get in weeks earlier.

“It’d be a very devastating thing for women not to be able to make their own choice, and have to wait a month and be even further along, to not be able to do this,” she said.

Another woman drove 100 miles with her husband to get here because the abortion clinics that were near her town had closed — and because the birth of her first child, she says, nearly killed her.

“I had a severe complication in the birth process, and the doctor advised me not to have any more — so here we are,” she told us. Her husband ferociously interrupted our interview to say he did not want to be a widower raising a child without his wife.

Isaac, the co-author of HB 2, says that women who live hundreds of miles from the nearest clinic should acknowledge that reality and act accordingly.

“Hopefully,” Isaac said, “they’ll be more preventative and not get pregnant.” Women who live far from a clinic should realize, he said, that “hey, that might still be an option legally — but now I live 300 miles away from the nearest place, I should probably be more careful.”

Despite the death of Justice Scalia last month, Justice Anthony Kennedy remains the likely swing vote in the Texas abortion case. If he votes to strike down the law, there would be at least a 5-to-3 majority for that outcome. But if he votes to uphold the law, the court likely would be tied on a 4-to-4 vote. That would leave the Texas abortion law in place, at least until a full nine-justice court considers the issue at some later time.

Beyond Texas, that would affect 13 other states that have enacted similar laws. Some have been blocked by the lower courts while others have not — and until the issue is resolved, the lower regional court decisions will dictate the results, state by state.

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Basketball's 3-Pointer: From Tacky Gimmick To Strategic Platform

Stephen Curry, right, of the Golden State Warriors dribbles toward Pablo Prigioni of the Los Angeles Clippers during the first half of a game at Staples Center on Feb. 20.

Stephen Curry, right, of the Golden State Warriors dribbles toward Pablo Prigioni of the Los Angeles Clippers during the first half of a game at Staples Center on Feb. 20. Sean M. Haffey/Getty Images hide caption

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It was not that long ago when the accepted wisdom in football was that the running game had to be established — that was always the obligatory verb, established — before passes could become effective. My, we know how that has changed. Now the pass is established from the get go, and running is an afterthought.

Well, I think it is certified now that basketball has experienced the same sort of offensive sea change. At all levels — with men and women — the 3-point shot has utterly transformed the way the game is played. More and more, the players are spread out, looking to pop behind the 3-point arc. More and more teams are, in the vernacular, “going small,” with only one big man down deep. Good grief, the position of power forward is in the process of going the way of short shorts.

Click the audio to hear Frank Deford’s full two cents on the 3-point shot.

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PHOTOS: Scenes From Super Tuesday

Primary voters cast their ballots Tuesday at Fairfax Circle Baptist Church in Fairfax, Va.

Donald Trump and Hillary Clinton scored big wins on Super Tuesday, after a day of voting in more than a dozen states. Scroll down for scenes from the day, from polling places and campaign events to candidate speeches at some unique venues.

Primary voters cast their ballots Tuesday at Fairfax Circle Baptist Church in Fairfax, Va. Chip Somodevilla/Getty Images hide caption

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Supporters of Republican presidential candidate. Marco Rubio photograph him as he speaks during a campaign rally at Courtyards of Andover Event Center in Andover, Minn.

Supporters of Republican presidential candidate. Marco Rubio photograph him as he speaks during a campaign rally at Courtyards of Andover Event Center in Andover, Minn. Stephen Maturen/Getty Images hide caption

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A Georgia voter casts his ballot at a fire station in Adairsville, Ga.

A Georgia voter casts his ballot at a fire station in Adairsville, Ga. Branden Camp/Getty Images hide caption

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Attendees wait in line to enter a Super Tuesday night rally for Bernie Sanders in Essex Junction, Vt. The Vermont senator dominated his home state's primary, winning more than 85 percent of the vote.

Attendees wait in line to enter a Super Tuesday night rally for Bernie Sanders in Essex Junction, Vt. The Vermont senator dominated his home state’s primary, winning more than 85 percent of the vote. Ian Thomas Jansen-Lonnquist/Bloomberg via Getty Images hide caption

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Republican presidential candidate John Kasich addresses an audience, including former Speaker of the House Newt Gingrich (second from right) and his wife, Callista Gingrich, during a town hall-style meeting at George Mason University Law School in Fairfax, Va.

Republican presidential candidate John Kasich addresses an audience, including former Speaker of the House Newt Gingrich (second from right) and his wife, Callista Gingrich, during a town hall-style meeting at George Mason University Law School in Fairfax, Va. Chip Somodevilla/Getty Images hide caption

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Republican voters line up outside a polling place in Anchorage, Alaska. The Republican caucus there was the last Super Tuesday contest, ending at midnight ET.

Republican voters line up outside a polling place in Anchorage, Alaska. The Republican caucus there was the last Super Tuesday contest, ending at midnight ET. Michael Dinneen/AP hide caption

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Republican presidential candidate Ben Carson waves to supporters during an election night party in Baltimore.

Republican presidential candidate Ben Carson waves to supporters during an election night party in Baltimore. Jose Luis Magana/AP hide caption

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A voter casts her ballot at the polling location inside the county's courthouse building in Marion, Ark. Arkansas had 40 Republican delegates and 32 Democratic delegates at stake in its primaries.

A voter casts her ballot at the polling location inside the county’s courthouse building in Marion, Ark. Arkansas had 40 Republican delegates and 32 Democratic delegates at stake in its primaries. Andrea Morales/Getty Images hide caption

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Donald Trump speaks onstage as New Jersey Gov. Chris Christie (left) stands nearby during a Super Tuesday night event at Trump property Mar-a-Lago in Palm Beach, Fla.

Donald Trump speaks onstage as New Jersey Gov. Chris Christie (left) stands nearby during a Super Tuesday night event at Trump property Mar-a-Lago in Palm Beach, Fla. Luke Sharrett/Bloomberg via Getty Images hide caption

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Hillary Clinton exits the stage after speaking during a Super Tuesday night rally in Miami.

Hillary Clinton exits the stage after speaking during a Super Tuesday night rally in Miami. Daniel Acker/Bloomberg via Getty Images hide caption

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Former CEO Charged With Rigging Bids For Oil And Gas Leases

Aubrey McClendon, former CEO of Chesapeake Energy Corp., has been indicted on charges of fixing bids for oil and gas leases in Oklahoma.

Aubrey McClendon, former CEO of Chesapeake Energy Corp., has been indicted on charges of fixing bids for oil and gas leases in Oklahoma. Sue Ogrocki/AP hide caption

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Aubrey McClendon, the former CEO of Chesapeake Energy Corp., was charged Tuesday with orchestrating a conspiracy not to compete for oil and gas leases in northwest Oklahoma, the Justice Department said.

The DOJ explained in a statement:

During this conspiracy, which ran from December 2007 to March 2012, the conspirators would decide ahead of time who would win the leases. The winning bidder would then allocate an interest in the leases to the other company. McClendon instructed his subordinates to execute the conspiratorial agreement, which included, among other things, withdrawing bids for certain leases and agreeing on the allocation of interests in the leases between the conspiring companies.

Each violation of the Sherman Act carries a maximum penalty of 10 years in prison and a $1 million fine for individuals, the DOJ said.

McClendon left Chesapeake in 2013 and founded American Energy Partners. According to ESPN, he also owns an estimated 20 percent of the NBA’s Oklahoma City Thunder.

Joe Wertz of StateImpact Oklahoma reported for our newscast unit:

“A spokesman for [Chesapeake], which was not named in the indictment, said it has been cooperating with federal authorities for some time. McClendon could not be reached for comment.”

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Presidential Candidates Await Results In Super Tuesday Contests

On the Republican side, Donald Trump is projected to win in Georgia. For the Democrats, Hillary Clinton takes Georgia and Virginia, while Bernie Sanders won in his home state of Vermont.

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Donald Trump Projected To Win GOP Primary In Georgia

Donald Trump is projected to win the Republican primary in Georgia. NPR’s Ari Shapiro talks to Ron Nehring, California chairman for the Ted Cruz campaign and formerly the California GOP chairman.

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Rep. Joaquin Castro On Hillary Clinton's Campaign After Super Tuesday

NPR’s Ari Shapiro interviews Rep. Joaquin Castro of Texas about how things are looking for Hillary Clinton on Super Tuesday. She is projected to win the Democratic primaries in Virginia and Georgia.

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